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Injury to airway and alveolar epithelium may result from chemical reactions of Cl2, from HOCl (the hydrolysis product of Cl2), and\/or from the various reaction products, such as chloramines, that are formed from the reactions of these chlorinating species with biological molecules. Subsequent reactions may initiate self-propagating reactions and induce the production of inflammatory mediators compounding injury to pulmonary surfactant, ion channels, and components of lung epithelial and airway cells. Low-molecular-weight antioxidants, such as ascorbate, glutathione, and urate, present in the lung epithelial lining fluid and tissue, remove Cl2 and HOCl and thus decrease injury to critical target biological targets. However, levels of lung antioxidants of animals exposed to Cl2 in concentrations likely to be encountered in the vicinity of industrial accidents decrease rapidly and irreversibly. Our measurements show that prophylactic administration of a mixture containing ascorbate and desferal N-acetyl-cysteine, a precursor of reduced glutathione, prevents Cl2-induced injury to the alveolar epithelium of rats exposed to Cl2. The clinical challenge is to deliver sufficient quantities of antioxidants noninvasively, after Cl2 exposure, to decrease morbidity and mortality.<\/jats:p>","DOI":"10.1513\/pats.201001-009sm","type":"journal-article","created":{"date-parts":[[2010,7,2]],"date-time":"2010-07-02T17:59:19Z","timestamp":1278093559000},"page":"278-283","source":"Crossref","is-referenced-by-count":85,"title":["Mechanisms and Modification of Chlorine-induced Lung Injury in Animals"],"prefix":"10.1093","volume":"7","author":[{"given":"Amit K.","family":"Yadav","sequence":"first","affiliation":[{"name":"Departments of Anesthesiology, School of Medicine"},{"name":"Department of Environmental Health Sciences, School of Public Health; and Centers for"},{"name":"Pulmonary Injury and Repair and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Bracher","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology, School of 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